If you’re suddenly feeling like you’re entering early dementia, have physically aged 50 years overnight, or contracted some sort of disease, the answer is likely none of the above.
Perimenopause is more than just a new social media trend. It’s a stage of hormonal change that occurs in the years leading up to full menopause, and despite it’s natural inevitability, ‘peri’ – as some women often call it – feels like a giant kick in the ass from Mother Nature. The most significant change is a huge drop in estrogen, a sex hormone that also acts as a neurotransmitter, though declines in testosterone and progesterone also have a major effect on the symptoms felt during this period of life.
Losing estrogen effects almost every part of your body, from menstrual cycle to mood to memory, and even ability to gain muscle mass and maintain skin elasticity.
Though perimenopause generally begins sometime between the ages of 40 and 50, some women have pinpointed their symptoms as early as age 33 to 35. The average length of peri is around 4 to 10 years, and for most, symptoms are felt right up until full menopause occurs, which puts some women at between 15 to 18 years of perimenopause.
While it seems drastic, many women who enter perimenopause do, indeed, feel like they’ve must have lost a ton of IQ points or jumped from age 45 to age 85 in the span of a single night. While perimenopause and menopause aren’t diseases, the life-changing symptoms that begin in the peri stage can truly feel like you must have something seriously wrong with you.
Finding a doctor through the The Menopause Society’s practitioner directory can help if you’re seeking a diagnosis and treatments, often in the form of HRT or hormone replacement therapy.
But in the meantime, if you’re currently losing your mind over symptoms that just don’t line up with your otherwise normal, healthy lifestyle, it could be perimenopause sneaking up on you, even if you think you’re too young.
Weird and Wonky Menstrual Cycles
Period issues are often the first sign of perimenopause, and though this isn’t always the case for every woman, menstrual cycle changes can define a major part of diagnosis for this stage of life change.
According to Dr. Jen Gunter, “when a women starts skipping two menstrual periods in a row, there is a 95% chance her final menstrual period will be within the next four years,” but this isn’t the only period-related symptom that should be taken into account when being diagnosed for peri.
Any or all of these symptoms can happen during perimenopause, including late periods; early periods; periods that are all otherwise over the map in terms of timing; skipped periods; major changes in lightness or heaviness of bleeding; passing large clots; and spotting in-between periods.
Always check with a gyno if your bleeding patterns are consistently off, as this can also be a sign of something more serious and time-sensitive.
Moderate to Severe Hair Loss
Thought hair loss could only happen to chemotherapy patients or women in their 80s? Unfortunately not.
Hair loss can occur in women of any age due to Androgenic Alopecia or female pattern hair loss, a type of hair loss characterized by the overproduction of DHT, an androgen called dihydrotestosterone, which causes hair to fall out too early in the hair fall cycle and can also shrink hair follicles, so hair grows back thinner.
Even if you’re not in perimenopause, you can still experience female pattern baldness, but it’s more likely to occur as estrogen drops. Even women in their early to mid-30s have reported serious hair loss issues.
The most common hair loss drug is Minoxidil, which can help regrow hair. ‘Minox,’ as it’s nicknamed, can be bought over the counter in a topical form, or prescribed in pill form by a doctor. However, some doctors also bundle a Minox prescription with Spironolactone, which inhibits the production of DHT, so as the Minox regrows hair, ‘Spiro’ can stop it from falling out too quickly.
If you’re seeking early advice or support, women’s Reddit groups like R/femalehairloss are a great place to begin researching causes and natural or pharmaceutical remedies. Otherwise, a perimenopause specialist, endocrinologist, or general practitioner can help pinpoint a cause and treatment plan for your hair loss.
Memory Problems, Mood Issues, and an Increase in Symptoms for ADHD and Neurodivergent Folks
Did you know estrogen, while still technically labeled as a hormone, is believed to also function as a neurotransmitter? As estrogen levels drop, your brain is thrown off balance in a lot of ways, including effecting your mood. Many women say they experience rage-like anger and have difficulty finding happiness in formerly enjoyed hobbies or leisure activities.
From forgetting everyday, common words far more often than usual to forgetting why you entered a room to getting in the car and forgetting how to drive your daughter to her school (yes, this literally happened to one woman!), estrogen supports memory function and learning, too.
If you were formerly sharp as a tack (and even if you weren’t), and now you can barely function at work, school, or home due to mental health symptoms like severe brain fog, memory loss, zero motivation or attention span, and even loss of joy over things that used to make you happy, perimenopause could be to blame.
For those who already struggle with memory, motivation, and cognitive function due to neurodivergent conditions like ADHD, autism, bi-polar disorder and depression, or other mental health spectrum diagnosis, symptoms can worsen in what feels like a 1,000x increase. Some women find their meds become less effective, or stop working altogether.
Online support groups like R/perimenopause or R/perimenopause_under45 on Reddit can help greatly as you navigate symptoms and doctor visits.
Sudden Signs of Physical Aging
Estrogen is known as the beauty hormone for good reason. When your body stops producing enough of it, you’ll feel like your face started to melt off overnight. Sagging jowls, wrinkles, thinned ‘crepey’ skin, and severe dryness are just some of the changes you’ll notice in your face and body as you enter perimenopause.
Many physical, beauty-related symptoms of perimenopause are just that: related to beauty standards alone and not dangerous to your health or functionality. However, we get it: you knew you were going to age, but not this early or this drastically, and quickly.
If you and your doctor decide it’s right for you, HRT or hormone replacement therapy can help in restoring estrogen’s benefits to your skin, though we wouldn’t recommend taking hormones for beauty reasons alone. The impacts and side effects of hormonal therapy on the body, both positive and negative, should be taken into account before starting treatment, and therefore your symptoms should extend beyond wrinkles and thinning lips.
Some women have also seen benefits from prescription estrogen skin creams from either their regular doctor or an online medical service like Musely or Midi. However, other women have seen zero improvements or developed melasma from using estrogen creams, so proceed with caution.
The Bottom Line: Find a Doctor That Listens to Your Concerns
Hormone levels can vary wildly during perimenopause, so it can be difficult or even impossible for a single blood test to indicate a diagnosis. Perimenopause is generally diagnosed based on symptoms alone, though some doctors will order blood work to rule out any other potential causes or more serious ailments.
Perimenopause has caused something of a recent stir in the medical community, leading some doctors to dismiss it as a TikTok fad, telling women that they’re “too young” to start peri, or that their distressing symptoms are just signs of normal aging. Though perimenopause is a normal part of the aging process, the associated symptoms can become so severe that they interfere with a healthy, happy lifestyle, even when you’re exercising, eating right, and caring for your mental wellness.
The bottom line is that you may have to get a 2nd, 3rd, or even 4th opinion before you find a doctor that takes your symptoms and health seriously, so don’t be discouraged if your first appointment doesn’t lead anywhere.
You can’t escape perimenopause, but you can do something about how it effects your holistic health!
